The median income for a primary care doctor is $122k
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Physicians need a specialty in order to charge more from the insurance companies. So many plans use the primary care physicians as gatekeepers to limit access to the pricier specialists, and they spend much of their time managing the referral process rather than practicing medicine.
I believe the new Obamacare, if it exists as discussed in its early stages, takes away that gatekeeper function and allows patients to see specialists directly and if so, would be another reason for the higher rates than under the existing system.
In my limited personal experience, even if insurance doesn’t require a referral, specialists want one so they aren’t wasting their time on hypochondriacs.
There is that, but there are those that like to go from specialist to specialist to find someone that will claim the diagnosis. Your guess as to which specialist to see is probably not much better than mine.
The idea is similar to the different levels at IT help desks, the first level (primary physicians) are excellent at getting you to the right specialist and getting feedback from the specialist if it was not the right call.
When I have seen a specialist, regarding of the insurance requirements, their first questions are always “what doctor sent you here and do you have any paperwork? The same symptoms can have many causes and it makes sense to rule out the most common causes before beginning down the paths of exotic causes.
PCPs are in competion with NPs & PAs…… (Primary Care Physicians, Nurse Practitioners & Physicians Assistants).